| NDC-11 (Package) | NDC-9 (Product) | Generic Name | Brand Name | Strength | SEER*Rx Category | Major Class | Minor Class | Administration Route | Package Effective Date | Package Discontinuation Date | Status |
|---|---|---|---|---|---|---|---|---|---|---|---|
| 00781-3498-95 | 00781-3498 | Arsenic Trioxide | Arsenic Trioxide | 2.0 mg/mL | Chemotherapy | Miscellaneous Agent | PML/RARa | Intravenous | May 19, 2022 | In Use | |
| 70518-4302-00 | 70518-4302 | HYDROXYUREA | HYDROXYUREA | 500.0 mg/1 | Chemotherapy | Miscellaneous Agent | Antimetabolite/Organooxygen | Oral | Mar 4, 2025 | In Use | |
| 00015-3080-60 | 00015-3080 | Mitotane | Lysodren | 500.0 mg/1 | Chemotherapy | Miscellaneous Agent | Adrenal Suppressant | Oral | Jun 1, 2009 | Mar 31, 2021 | No Longer Used |
| 00781-3498-94 | 00781-3498 | Arsenic Trioxide | Arsenic Trioxide | 2.0 mg/mL | Chemotherapy | Miscellaneous Agent | PML/RARa | Intravenous | May 19, 2022 | In Use | |
| 54868-4773-01 | 54868-4773 | Hydroxyurea | Hydroxyurea | 500.0 mg/1 | Chemotherapy | Miscellaneous Agent | Antimetabolite/Organooxygen | Oral | Apr 11, 2003 | In Use | |
| 51407-0909-01 | 51407-0909 | HYDROXYUREA | HYDROXYUREA | 500.0 mg/1 | Chemotherapy | Miscellaneous Agent | Antimetabolite/Organooxygen | Oral | Apr 22, 2024 | In Use | |
| 72162-1118-01 | 72162-1118 | Pilocarpine hydrchloride | Pilocarpine hydrchloride | 5.0 mg/1 | Ancillary Therapy | Miscellaneous Agent | Cholinergic Agonist | Oral | Oct 6, 2023 | In Use | |
| 54868-4773-00 | 54868-4773 | Hydroxyurea | Hydroxyurea | 500.0 mg/1 | Chemotherapy | Miscellaneous Agent | Antimetabolite/Organooxygen | Oral | Apr 11, 2003 | In Use | |
| 67386-0411-51 | 67386-0411 | Asparaginase (E. coli) | Elspar | Chemotherapy | Miscellaneous Agent | Enzyme | Intramuscular | Jan 10, 1978 | Jul 18, 2013 | No Longer Used | |
| 68084-0284-01 | 68084-0284 | Hydroxyurea | Hydroxyurea | 500.0 mg/1 | Chemotherapy | Miscellaneous Agent | Antimetabolite/Organooxygen | Oral | Sep 17, 2008 | In Use | |
| 54868-4773-03 | 54868-4773 | Hydroxyurea | Hydroxyurea | 500.0 mg/1 | Chemotherapy | Miscellaneous Agent | Antimetabolite/Organooxygen | Oral | Apr 11, 2003 | In Use | |
| 54868-4773-02 | 54868-4773 | Hydroxyurea | Hydroxyurea | 500.0 mg/1 | Chemotherapy | Miscellaneous Agent | Antimetabolite/Organooxygen | Oral | Apr 11, 2003 | In Use | |
| 70518-0916-01 | 70518-0916 | Hydroxyurea | Hydroxyurea | 500.0 mg/1 | Chemotherapy | Miscellaneous Agent | Antimetabolite/Organooxygen | Oral | Dec 18, 2019 | In Use | |
| 67184-0607-01 | 67184-0607 | HYDROXYUREA | HYDROXYUREA | 500.0 mg/1 | Chemotherapy | Miscellaneous Agent | Antimetabolite/Organooxygen | Oral | Mar 6, 2024 | In Use | |
| 64764-0800-28 | 64764-0800 | MARIBAVIR | Livtencity | 200.0 mg/1 | Ancillary Therapy | Miscellaneous Agent | CMV Antiviral | Oral | Nov 23, 2021 | In Use | |
| 81607-0006-07 | 81607-0006 | Arsenic trioxide | ARSENIC TRIOXIDE | 2.0 mg/mL | Chemotherapy | Miscellaneous Agent | PML/RARa | Intravenous | May 31, 2023 | In Use | |
| 72205-0171-07 | 72205-0171 | ARSENIC TRIOXIDE | ARSENIC TRIOXIDE | 1.0 mg/mL | Chemotherapy | Miscellaneous Agent | PML/RARa | Intravenous | Feb 6, 2024 | In Use | |
| 72694-0515-01 | 72694-0515 | Calaspargase Pegol | Asparlas | 750.0 U/mL | Chemotherapy | Miscellaneous Agent | Enzyme | Intravenous | Sep 27, 2019 | In Use | |
| 81561-0413-05 | 81561-0413 | asparaginase | ERWINASE | 10000.0 [iU]/mL | Chemotherapy | Miscellaneous Agent | Enzyme | Intramuscular, Intravenous | Jun 1, 2021 | In Use | |
| 70518-0916-00 | 70518-0916 | Hydroxyurea | Hydroxyurea | 500.0 mg/1 | Chemotherapy | Miscellaneous Agent | Antimetabolite/Organooxygen | Oral | Dec 20, 2017 | In Use | |
| 25021-0226-10 | 25021-0226 | Arsenic Trioxide | Arsenic Trioxide | 1.0 mg/mL | Chemotherapy | Miscellaneous Agent | PML/RARa | Intravenous | Feb 15, 2023 | In Use | |
| 60429-0265-01 | 60429-0265 | Hydroxyurea | Hydroxyurea | 500.0 mg/1 | Chemotherapy | Miscellaneous Agent | Antimetabolite/Organooxygen | Oral | Oct 26, 2012 | Dec 31, 2024 | No Longer Used |
| 00006-5331-58 | 00006-5331 | Belzutifan | WELIREG | 40.0 mg/1 | Chemotherapy | Miscellaneous Agent | HIF-2 alpha | Oral | Jun 21, 2023 | In Use | |
| 72205-0172-07 | 72205-0172 | ARSENIC TRIOXIDE | ARSENIC TRIOXIDE | 2.0 mg/2mL | Chemotherapy | Miscellaneous Agent | PML/RARa | Intravenous | Feb 6, 2024 | In Use | |
| 00555-0882-02 | 00555-0882 | Hydroxyurea | Hydroxyurea | 500.0 mg/1 | Chemotherapy | Miscellaneous Agent | Antimetabolite/Organooxygen | Oral | Oct 19, 1998 | In Use |
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